ABSTRACT
To investigate the clinical features of Kikuchi-Fujimoto disease (KFD) and the relationship between viral infection and this disease in children will be better as Kikuchi-Fujimoto disease (KFD) is a lymphadenopathy. The aim of study is to investigate the clinical features of KFD and the relationship. The age, gender, clinical features and aetiopathogenesis of 36 Chinese children with FKD were reviewed, and the viral antigens were detected. Mean age was 10.1 ± 2.8 yr with a male to female ratio of 1.8:1. Fever and lymphadenopathy were the most common complaints, noted in 23 and all cases respectively. Skin rash and hepatosplenomegaly were also noted. Leukopenia, anemia, thrombocytopenia and raised ESR were noted in 21, 6, 4 and 31 cases respectively. Epstein-Barr virus (EBV) IgM and IgG was positive in 1 and 24 of 29 cases respectively. Antigens of EBV and herpes simplex virus 2 (HSV 2) were found in the biopsy tissue section from 2 and 1 case respectively. Autoantibodies were noted in 3 of 15 cases. Steroid hormones were administrated for 19 cases with good efficacy. These results imply that children with lymphadenopathy and/or fever may have KFD and thus excisional biopsy of lymph nodes should be performed earlier on. A hyperimmune reaction of immune cells to EBV and HSV2 may play a role in the pathology of KFD.
Subject(s)
Adolescent , Adrenal Cortex Hormones/therapeutic use , Biopsy , Child , Child, Preschool , China/epidemiology , Diagnosis, Differential , Female , Histiocytic Necrotizing Lymphadenitis/diagnosis , Histiocytic Necrotizing Lymphadenitis/drug therapy , Histiocytic Necrotizing Lymphadenitis/epidemiology , Histiocytic Necrotizing Lymphadenitis/immunology , Humans , Infant , MaleABSTRACT
Kikuchi-Fujimoto disease also known as histiocytic necrotizing lymphadenopaty (HNL) is a rare entity, originally described in Japanese population, although currently it has been described all over the world. It is more frequent in young women and it is usually located in cervical lymph nodes. We report 14 cases of HNL in Mexican population, their clinicopathological and immunohistochemical study as well as a comparative study with other necrotizing lymphadenopaties due to B or T-cell lymphomas, tuberculosis, Epstein Barr virus infection, and non-specific necrosis. In our study we found that there was more expression of the immunomarkers CD68, MPO, CD123 and antikerat in OSCAR in the cases of HNL in contrast with the lesser or even null expression of the same markers in the necrotized lymph nodes of the comparative study group.
La enfermedad de Kikuchi-Fujimoto o linfadenitis histiocítica necrosante (LHN) es una entidad poco frecuente, inicialmente descrita en población japonesa. Sin embargo, actualmente se ha descrito alrededor de todo el mundo. Es más frecuente en mujeres jóvenes y su localización habitual es en ganglios linfáticos cervicales. Presentamos estudio clinicopatológico de 14 casos de LHN en pacientes mexicanos, y los comparamos con linfadenitis necrosantes secundarias a linfomas B y T, tuberculosis, virus de Epstein Barr y necrosis inespecífica. Encontramos mayor expresión de los anticuerpos CD68, MPO, CD 123 y antiqueratina OSCAR en los casos de LHN comparados con la expresión baja o nula de los mismos anticuerpos en las necrosis ganglionares del grupo comparativo.
Subject(s)
Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Histiocytic Necrotizing Lymphadenitis/pathology , Diagnosis, Differential , Histiocytic Necrotizing Lymphadenitis/immunology , Immunohistochemistry , Lymphatic Diseases/diagnosis , NecrosisABSTRACT
La enfermedad de Kikuchi o Kikuchi Fujimoto o linfadenitis histiocítica necrotizante, es una rara y habitualmente benigna enfermedad que se presenta con fiebre y adenopatías cervicales usualmente en mujeres jóvenes. La etiología es desconocida, aunque hay evidencias de su origen viral y la semejanza del grupo poblacional afectado con el lupus eritematoso sistémico ha alentado, en base a estudios celulares, la sospecha de que el síndrome de Kikuchi refleja una condición Lupus - símil auto limitada y causada por linfocitos transformados por una infección viral. Inicialmente descripta en Japón, la enfermedad de Kikuchi Fujimoto se ha reportado en diferentes grupos étnicos y raciales, aunque ha sido predominantemente descripto en Asia. La enfermedad puede ser sospechada por la clínica pero se necesita de la anatomía patológica para su confirmación.